Provider Demographics
NPI:1669553467
Name:STEPHENS, JAMES DRANE (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DRANE
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SHELBY ST
Mailing Address - Street 2:
Mailing Address - City:EMINENCE
Mailing Address - State:KY
Mailing Address - Zip Code:40019-1350
Mailing Address - Country:US
Mailing Address - Phone:502-518-9120
Mailing Address - Fax:502-518-9123
Practice Address - Street 1:5551 S MAIN ST
Practice Address - Street 2:
Practice Address - City:EMINENCE
Practice Address - State:KY
Practice Address - Zip Code:40019-1126
Practice Address - Country:US
Practice Address - Phone:502-518-9120
Practice Address - Fax:502-518-9123
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist